Medication guide for treating erectile dysfunction

Viagra, Cialis, Levitra, Spedra: complete guide to medications for erectile dysfunction

It has happened to you once, twice, then a few times. Haven't you taken the step to discuss it with your primary care physician yet? You've surely heard of Viagra® (sildenafil), maybe even Cialis® (tadalafil), but are you struggling to find a concise source of accessible and reliable information that can guide you?

Don't panic, here is an educational and explanatory guide to the medications available on the market to improve your erectile dysfunction. It will help you see things more clearly.

Phosphodiesterase type 5 inhibitors

PDE5 inhibitors are the most well-known medications for the treatment of erectile dysfunction. As inhibitors of an enzyme called phosphodiesterase, they promote the relaxation of the smooth muscles (refer to the 1st article) of the penile corpora cavernosa, thereby increasing the arterial blood flow that causes an erection. Available only by prescription, they act, when coupled with sexual stimulation, as facilitators of erection.

The 4 PDE5 inhibitors available on the market are the following:

Viagra®, whose active ingredient and generic drug is Sildenafil.

Cialis®, whose active ingredient and generic drug is Tadalafil.

Levitra®, whose active ingredient and generic drug is Vardenafil.

Spedra®, whose active ingredient and generic drug is Avanafil.

Generic PDE5 inhibitors are substantially identical to the original medications, and may offer lower costs. (7)

All clinical trials prove their effectiveness, which varies from 60 to 75%. In the case of taking Sildenafil in particular, 75% of men report having their erection restored. They can therefore be a long-term treatment or an excellent adjunctive treatment for men with ED. While they do have some side effects, as all medications do, which we will detail, these treatments are well tolerated by the majority of patients.

But what are they?

Sildenafil (Viagra®)

It has been available on the European market since 1998 in tablet form, with dosages ranging from 25 to 100 mg. The generally recommended dose is 50 mg, but it can go up to 100 mg, with the dosage needing to be adjusted to several variables unique to each man, such as pre-existing conditions, cardiovascular health, or the frequency of taking the medication. It should be taken 30 minutes to 1 hour before sexual intercourse, knowing that it acts faster if taken on an empty stomach. Viagra® can remain in the blood for an average of up to 4 to 5 hours and facilitate multiple erections.

Easy and effective treatment, it is the right choice if you are looking for a temporary solution, which will require a bit of planning ahead.

Like any medication, it has side effects that are more or less likely, and can be avoided with the correct dosage, such as nausea, hot flashes, nasal congestion, or digestive disorders.

Viagra® is not recommended for individuals with cardiovascular problems, in combination with nitrate vasodilators, that is, medications capable of dilating blood vessels, in cases that have not yet been studied (hypotension, liver failure, stroke, etc.), in the event of vision impairment due to optic nerve damage, or when taking alpha-blockers.

Nitrate vasodilators are often heart medications, but are also found in recreational substances such as "poppers", which should be avoided if taking Viagra®. It is also advised not to combine them with anti-HIV treatments (ritonavir, atazanavir, tipranavir, etc).

Its dosage and frequency of administration must be determined imperatively with a doctor. (1) (2) (3)

Tadalafil (Cialis®)

It has been available on the European market since 2003, in tablet form, dosed from 2.5 to 20 mg. Cialis® can be taken in two different ways:

• Take it 30 minutes to 1 hour before sexual intercourse to induce an erection. It works in the same way as Viagra with the major difference that it can be effective for up to 36 hours after taking it.
• Either as a continuous treatment, to be taken every day at roughly the same time. The 2.5 to 5 mg tablets are suitable for daily intake, which is recommended for men who have more than two sexual encounters per week and who want to be able to have an erection at any time.

With the same properties as Viagra®, the side effects and contraindications are identical. Daily use may result in longer-lasting side effects. (2) (4)

Vardenafil (Levitra®)

It has been available on the European market since 2003, in tablet form, dosed from 5 to 10 mg. Levitra® is very similar to Viagra. It is taken 30 to 60 minutes before sexual intercourse and, when combined with sensory sexual stimulation, can be effective for up to 5 hours. Unlike Viagra®, Levitra® is not affected by food intake and will maintain the same effectiveness at any time of the day.

The contraindications and side effects are substantially identical to those of Viagra®. Remember to fully inform your doctor of all your medical history and to consult the leaflets if in doubt. (4) (5)

Avanafil (Spedra®)

It has been available on the market since 2013, in tablet form, dosed from 50 to 200 mg. According to the manufacturer, its action is a bit faster than that of other PDE5 inhibitors as it can be taken 15 to 30 minutes before intercourse. It will be more effective if taken on an empty stomach. The effects of Spedra® can last up to 6 hours.

Its contraindications and side effects are also the same as those of Viagra®.(4) (6)

Perhaps you prefer to take a pill when necessary, or undergo continuous treatment if you have an active sex life and to avoid having to anticipate. Lifestyle habits, medical history, preferences... The choice of treatment and its dosage must be made taking into account these various variables. Only a doctor can guide you. The first step is to dare to talk about it and to consult.